实用医学杂志 ›› 2021, Vol. 37 ›› Issue (9): 1136-1140.doi: 10.3969/j.issn.1006⁃5725.2021.09.008

• 临床研究 • 上一篇    下一篇

多裂肌横截面积与经皮椎间孔镜治疗腰椎间盘突出症患者预后的关系

陈齐齐, 陈立平, 金军, 樊敏,申文   

  1. 徐州医科大学附属医院1 疼痛科,2 影像科(江苏徐州 221000)

  • 出版日期:2021-05-10 发布日期:2021-05-10
  • 通讯作者: 申文 E⁃mail:waterblue1988@126.com
  • 基金资助:
    国家自然科学基金面上项目(编号:81571066)

Relationship between cross⁃sectional area of multifidus muscle and prognosis of patients with lumbar disc herniation treated by percutaneous endoscopic transforaminal discectomy 

CHEN QiqiCHEN LipingJIN JunFAN MinSHEN Wen.    

  1. Department of Pain,Xuzhou Hospital,Xuzhou University,Xuzhou 221000,China 

  • Online:2021-05-10 Published:2021-05-10
  • Contact: SHEN Wen E⁃mail:waterblue1988@126.com

摘要:

目的 评估多裂肌横截面积对经皮椎间孔镜手术(percutaneous endoscopic transforaminal dis⁃cectomy,PETD)治疗腰椎间盘突出症患者预测术后复发的价值,为临床治疗提供可靠的依据,以期降低术后复发率。方法 收集 2016 1 月至 2020 2 月于我院疼痛科接受 PETD 治疗的 155 L5⁃S1椎间盘突出症患者,根据是否复发分为复发组(17 例)和未复发组(138 例),分析比较其临床资料。应用 MRI 成像, Image J 软件测量与椎间盘突出侧的多裂肌横截面积(cross⁃sectional area,CSA)和脂肪浸润度(degree of fat infiltration,DFF)。采用 logistic 回归分析影响复发的独立危险因素,ROC 曲线评估多裂肌 CSA 的预测价值。结果 复发组和未复发组在性别、病程、手术时间、复工时间、椎间盘突出位置,椎间隙高度无统计学差异,而两组患者在年龄、BMI、吸烟、饮酒、糖尿病、多裂肌 CSA DEF 的差异均有统计学意义(P 0.05)。ROC 曲线发现多裂肌 CSA 预测 PETD 术后复发的敏感性和特异性均更高。结论 多裂肌 CSA PETD 术后复发的独立危险因素,可准确预测PELD 术后的复发。

关键词:

多裂肌, 横截面积, 腰椎间盘突出, 经皮椎间孔镜手术, 术后复发

Abstract:

Objective To evaluate the value of cross⁃sectional area(CSA)of multifidus muscle in predict⁃ ing postoperative recurrence in patients with lumbar disc herniation treated by PETD so as to provide reliable basis for clinical treatment and reduce postoperative recurrence rate. Methods A total of 155 patients with L5 ⁃S1 disc herniation treated by PETD in the Department of Pain,Xuzhou Medical University Hospital from January 2016 to February 2020 were divided into recurrent group(n = 17)and non⁃recurrent group(n = 138). The clinical data were analyzed and compared. MRI was performed in all patients,and the CSA and the Degree of Fat Infiltration (DFF)of multifidus muscle of lumbar disc herniation were measured by Image J software. Logistic regression analysis was used to analyze the independent risk factors of recurrence,and ROC was used to evaluate the predictive value of multifida CSA. Results There was no significant difference in sex,course of disease,time of operation time for resuming work ,location of intervertebral disc herniation and height of intervertebral space between recurrent group and non⁃recurrent group,but there were significant differences in age,BMI,smoking,drinking diabetes,CSA and DEF between the two groups. ROC showed that CSA had high sensitivity and specificity in predicting recurrence after PETD. Conclusion CSA is an independent risk factor for recurrence after PETD and can accurately predict the recurrence rate after PELD. 

Key words:

polyschisis muscle, cross ?sectional area, lumbar disc herniation, percutaneous endo? scopic transforaminal discectomy, postoperative recurrence